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medical student had discovered that the light, tasty vapor was a safe, effective killer of his pain. In his days spent fighting the dancing gonococci, Larch had become quite a knowledgeable imbiber of ether. By the time the fierce bacteria had burned themselves out, Larch was an ether addict. He was an open-drop-method man. With one hand he held a cone over his mouth and nose; he made this mask himself (by wrapping many layers of gauze around a cone of stiff paper); with his other hand, he wet the cone. He used a quarter-pound ether can punctured with a safety pin; the drops that fell from the elbow of the safety pin fell in exactly the correct size and at exactly the correct rate.
    It was the way he would give ether to his patients, too, except that he gave himself much less; when the hand that held the ether can felt unsteady, he put the can down; when the hand that held the cone over his mouth and nose dropped to his side, the cone fell off his face—it wouldn’t stay in place if no one held it. He felt nothing of the panic that a patient being anesthetized with ether experiences—he never approached the moment when there wasn’t enough air to breathe. Before that happened, he always dropped the mask.
    When young Dr. Larch first set out from the South Branch of the Boston Lying-In to deliver babies in the poor districts of the city, he had a place in his mind where the peace of ether resided. Although he carried the ether can and the gauze cone with him, he didn’t always have time to anesthetize the patient. The woman’s labor was often too far advanced for the ether to help her. Of course he used it when he had the time; he would never share the opinion of some of his elder colleagues that ether was a deviation from the given—that children should be brought forth in pain.
    Larch delivered his first child to a Lithuanian family in a coldwater, top-floor apartment—the surrounding streets littered with squashed fruit and tattered vegetables and horse droppings. There was no ice to put on the abdomen, over the uterus, in case of postpartum hemorrhage. There was a pot of water already boiling on the stove, but Larch wished he could sterilize the entire apartment. He sent the husband out for ice. He measured the woman’s pelvis. He mapped out the fetus. He listened to its heartbeat while he watched a cat toying with a dead mouse on the kitchen floor.
    There was a would-be grandmother present; she spoke Lithuanian to the woman in labor. To Dr. Larch she spoke a strange language of gestures, which suggested to him that the would-be grandmother was feebleminded. She indicated that a large mole on her face was either a source of hysterical pleasure or hysterical pain—Larch couldn’t tell which; perhaps she simply wanted him to remove it, either before or after he delivered the baby. She found several ways to exhibit the mole—once by holding a spoon under it, as if it were about to fall; once capping it with a teacup and revealing it suddenly, as if it were a surprise or a kind of magician’s trick. But the zeal she brought to each revelation of the mole suggested to Wilbur Larch that the old woman simply forgot that she had already shown him her mole.
    When the husband returned with the ice, he trod on the cat, which voiced its disapproval in tones that made Wilbur Larch think the child was being born. Larch was grateful not to have to use the forceps; it was a short, safe, loud delivery, following which the husband refused to wash the baby. The grandmother offered, but Larch feared that her combination of excitement and feeblemindedness would cause an accident. Indicating (as well as he could, without the benefit of Lithuanian) that the child should be washed in warm water and soap—but not boiled in the pot on the stove, and not held head down under the coldwater tap—Larch turned his attention to the afterbirth, which refused to come away. The way the patient kept bleeding, Larch knew he would soon be faced